Quality of measurement properties of medication adherence instruments in cardiovascular diseases and type 2 diabetes mellitus: a systematic review and meta-analysis.

BACKGROUND: Medication adherence has a major impact on reducing mortality and healthcare costs related to the treatment of cardiovascular diseases and diabetes mellitus. Selecting the best patient-reported outcome measure (PROM) among the many available for this kind of patient is extremely important. This study aims to critically assess, compare and synthesize the quality of the measurement properties of patient-reported outcome measures to assess medication adherence among patients with cardiovascular diseases and/or type 2 diabetes mellitus. METHODS: This review followed the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines and was reported according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). The searches were performed in Web of Science, SCOPUS, PubMed, CINAHL, EMBASE, LILACS, PsycINFO, and ProQuest (gray literature). RESULTS: A total of 110 records encompassing 27 different PROMs were included in the review. The included records were published between 1986 and 2023, most of which reported studies conducted in the United States and were published in English. None of the PROMs were classified in the category "a", thus being recommended for use due to the quality of its measurement properties. The PROMs that should not be recommended for use (category "c") are the MTA, GMAS, DMAS-7, MALMAS, ARMS-D, and 5-item questionnaire. The remaining PROMs, e.g., MMAS-8, SMAQ, MEDS, MNPS, ARMS-12, MGT, MTA-OA, MTA-Insulin, LMAS-14, MARS-5, A-14, ARMS-10, IADMAS, MAQ, MMAS-5, ProMAS, ARMS-7, 3-item questionnaire, AS, 12-item questionnaire, and Mascard were considered as having the potential to be recommended for use (category "b"). CONCLUSION: None of the included PROMs met the criteria for being classified as trusted and recommended for use for patients with cardiovascular diseases and/or type 2 diabetes mellitus. However, 21 PROMs have the potential to be recommended for use, but further studies are needed to ensure their quality based on the COSMIN guideline for systematic reviews of PROMs. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019129109.

Methods to assess ambivalence towards food and diet: a scoping review.

BACKGROUND: Ambivalence towards food and diet, which favours behavioural inertia, might be a barrier to adopting healthier eating behaviours. Measuring it can help researchers to better understand its relationship with behaviour change and design interventions aimed at resolving it. In this scoping review, we map and describe methods and tools employed in studies to assess, measure or classify the ambivalence of participants towards food- and diet-related attitude objects. METHODS: In accordance with Joanna Briggs Institute guidance for conducting scoping reviews, we retrieved peer-reviewed studies from MEDLINE, CINAHL, PsycINFO, Web of Science, FSTA and Food Science Source and preprints from PsyArXiv and MedRxiv. Two independent reviewers screened the articles. We considered for inclusion peer-reviewed studies and preprints that assessed the ambivalence of participants of any age, sex or sociodemographic group towards food and diet. RESULTS: We included 45 studies published between 1992 and 2022, which included participants from 17 countries. Eighteen methods were employed across the included studies to assess different types of ambivalence (felt, potential or cognitive-affective), the most frequent of which were the Griffin Index, the Subjective Ambivalence Questionnaire, the MouseTracker Paradigm and the Orientation to Chocolate Questionnaire. CONCLUSION: This scoping review identified several methods and tools to assess different types of ambivalence towards food- and diet-related objects, providing an array of options for future studies.

Sociodemographic, clinical, and dietary characteristics of overweight adults: a secondary analysis of a population study / Caracterização sociodemográfica, clínica e da alimentação de adultos com excesso de peso: análise secundária de um estudo populacional

ABSTRACT Objective: To estimate the prevalence of overweight among Brazilian adults aged 20 to 59, according to sociodemographic characteristics, health-related behaviors, and food consumption. Methods: A cross-sectional study based on data from a population-based survey in a major metropolitan city in the state of São Paulo, Brazil, conducted between 2015-2016. Prevalences and prevalence ratios were estimated using Poisson regression; food consumption means were estimated using linear regression. Results: We analyzed data from 855 adults, 61% of whom were overweight. The prevalence of overweight was significantly higher among males, those aged 30 or older, with 8 to 11 years of education, and those who reported eating more than they should. The body mass index was significantly associated with hypertension, diabetes, high cholesterol, waist-to-height ratio, taking weight-loss medications, overeating, and the habit of checking labels. Overweight adults reported eating meat with visible fat and drinking soda more frequently than those not overweight. Overweight adults reported eating significantly more grams of food daily and had a higher intake of energy, total fat, saturated fats, trans fats, carbohydrates, protein, insoluble dietary fiber, sodium, and potassium. Their diets had a higher glycemic load when compared to participants who were not overweight. Conclusion: Adults with and without overweight differed in their sociodemographic, dietary, and clinical characteristics. Diet quality was similar between both groups, suggesting a need for improving dietary habits in this population regardless of body weight.

RESUMO Objetivo: Estimar a prevalência de excesso de peso entre adultos brasileiros, de 20 a 59 anos, segundo características sociodemográficas, de comportamentos relacionados à saúde e quanto ao consumo alimentar. Métodos: Estudo transversal, de pesquisa de base populacional, em uma cidade metropolitana de São Paulo - Brasil, conduzida entre os anos de 2015 e 2016. Foram estimadas as prevalências e as razões de prevalência por meio da regressão de Poisson, e as médias de consumo alimentar pelo uso da regressão linear. Resultados: Foram analisados dados referentes à 855 adultos, 61% destes apresentavam sobrepeso. A prevalência de excesso de peso foi significativamente maior entre: homens, com 30 anos ou mais, pessoas que possuíam entre 8 e 11 anos de estudo e entre aqueles que acreditavam comer mais do que deveriam. O índice de massa corporal foi significativamente associado à hipertensão, diabetes, colesterol alto, razão cintura-estatura, uso de medicamentos, comer mais do que deveria e o hábito de checar rótulos. Adultos com excesso de peso ingeriam carnes com gordura e refrigerantes em maior frequência quando comparados à adultos com peso saudável. Adultos com excesso de peso consumiam, significativamente, mais gramas de alimentos por dia e apresentaram maior ingestão de calorias, gorduras totais, saturadas e trans, carboidratos, proteína, fibras insolúveis, sódio e potássio. A dieta deles continha uma maior carga glicêmica quando comparada àqueles com peso saudável. Conclusão: Adultos com e sem excesso de peso, diferiram quanto às características sociodemográficas, dietéticas e clínicas. A qualidade da dieta foi similar em ambos os grupos, o que sugere a necessidade de melhora dos hábitos alimentares da população, independentemente do peso corporal.

Psychometric properties of medication adherence instruments in cardiovascular diseases and type 2 diabetes mellitus: systematic review protocol.

BACKGROUND: The pharmacological treatment of cardiovascular diseases and type 2 diabetes mellitus reduces the risk of cardiovascular events.; however, most patients do not adhere to the treatment. There are several self-reported measures for assessing medication adherence. Identifying the instruments with the best psychometric evidence is essential for selecting an accurate measure. The aim of this study is to critically assess, compare and synthesize the quality of the measurement properties of patient-reported outcome measures to access medication adherence among patients with cardiovascular diseases and/or type 2 diabetes mellitus. METHODS: This protocol is reported according to Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. The following databases will be searched: Web of Science, SCOPUS, PubMed, CINAHL, EMBASE, LILACS, PsycINFO and ProQuest. DISCUSSION: This review will provide a detailed assessment of the measurement properties of self-reported medication adherence instruments in patients with cardiovascular diseases and/or type 2 diabetes mellitus to support clinical practice and research. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019129109.

Do you think that you eat more than you should? Perception of adolescents from a Brazilian municipality.

OBJECTIVES: To estimate the prevalence of the perception of eating more than one should and the associated factors in adolescents, and to analyze differences in dietary indicators according to the perception of overeating. METHODS: This is a cross-sectional population-based study with a sample of 912 adolescents, participants of a food consumption survey conducted in 2015-2016, in Campinas, SP, Brazil. RESULTS: The prevalence of the perception of eating more than one should was 35.0%, and higher in those who declared themselves non-white, those who had excess weight, those who had high waist circumference, those who would like to change their weight, those who did something to lose weight, and those who evaluated themselves as fat. The prevalence rates were also higher in those who perceived the quality of their diet as poor, who had higher frequencies of consumption of sweets, soft drinks, cold meats, and lower frequencies of consumption of fruits, raw vegetables, and breakfast up to three times a week. Among those who considered themselves as overeating, higher intakes of energy, carbohydrate, protein, fat, added sugar, and sodium were observed, and prevalence rates of 38.5% for overweight and 66.2% for obesity were identified. CONCLUSION: The perception of eating more than one should was associated with unhealthy eating practices, the self-assessment of a poor quality diet, dissatisfaction with weight, and inadequate nutritional status. There is a need for further studies to investigate the application of the question "Do you think that you eat more than you should?" as a health behavior indicator.

Self-rated diet quality according to adolescents: ISACamp-Nutri results. / Qualidade da dieta segundo a autoavaliação de adolescentes: resultados do ISACamp-Nutri.

The aim was to estimate the prevalence of categories of self-rated diet quality according to adolescents, identify the reasons for not considering the diet very good/good as well as calculate the global Revised Brazilian Healthy Eating Index Revised (BHEI-r) score and component scores according to the self-assessment categories. A cross-sectional population-based study with two-stage stratified cluster sampling was conducted in Campinas-SP. A total of 891 adolescents were analyzed. The proportions of very good/good, fair and poor/very poor self-rated diet quality were 57.3%, 34.6% and 8.1%, respectively. Fair/poor/very poor self-rated diet quality was associated with the consumption of candy/sweets, snacks/cookies, whole grains (10-14 years) and fast food (15-19 years). Among those classified as having poor diet quality (1st tertile of BHEI-r scores), 52.5% considered their diet to be very good/good and only 13.1% considered their diet to be poor/very poor. The BHEI-r score was significantly lower among those who thought their diet was poor (50.0 points) compared to those who thought their diet was very good/good (55.4 points). Those who considered their diet to be poor had lower intakes of fruit and whole grains as well as higher intakes of solid fats and sugars. The findings reveal incoherence between self-rated diet quality and the observed unsatisfactory diet scores.

Objetivou-se estimar as prevalências de autoavaliação da qualidade da dieta de adolescentes e identificar os motivos de não a considerar muito boa/boa; calcular o escore global e de cada componente do Índice de Qualidade da Dieta Revisado (IQD-R) segundo as categorias de autoavaliação. Estudo transversal de base populacional com amostra por conglomerados e em dois estágios, realizado em Campinas-SP. Foram analisadas 891 entrevistas. As prevalências de autoavaliação da qualidade da dieta foram de 57,3% como muito boa/boa, 34,6% como regular e 8,1% como ruim/muito ruim. A autoavaliação como regular ou ruim foi associada ao consumo de doces, salgadinhos/biscoitos, cereais integrais (10-14 anos) e de fast-food (15-19 anos). Para os que foram classificados com pior qualidade da dieta (1º tercil dos escores do IQD-R), 52,5% consideravam a alimentação muito boa/boa e apenas 13,1% como ruim/muito ruim. O escore do IQD-R revelou-se significativamente menor nos que achavam a alimentação ruim (50,0 pontos) comparados aos que disseram muito boa/boa (55,4 pontos). Os que consideravam a alimentação ruim apresentaram consumo inferior de frutas, cereais integrais, e superior de gorduras sólidas e açúcares. Os achados revelam incoerência na autoavaliação da qualidade da dieta em relação aos escores insatisfatórios observados.

Effects of coconut oil consumption on energy metabolism, cardiometabolic risk markers, and appetitive responses in women with excess body fat.

PURPOSE: Virgin coconut oil (VCO) is a medium-chain fatty acid source with popularly attributed benefits on obesity management. However, its role on obesity requires elucidation due to its saturated nature. In the study herein, we investigated acute effects of VCO consumption on energy metabolism, cardiometabolic risk markers, and appetitive responses in women with excess body fat. METHODS: Fifteen adult women with excess body fat (37.43 ± 0.83%) participated in this randomized, crossover, controlled study. Two isocaloric mixed breakfasts containing 25 mL of VCO or control (extra-virgin olive oil-C) were evaluated. Resting energy expenditure (REE), fat oxidation rate (FOR), diet induced thermogenesis (DIT) and appetitive subjective responses were assessed at fasting and postprandial periods (up to 240 min). Cardiometabolic risk markers were assessed at fasting and up to 180 min postprandially. RESULTS: VCO did not affect REE, FOR, and DIT compared to C. In addition, VCO did not cause deleterious change in triglycerides, total cholesterol, HDL-c, LDL-c, triglycerides/HDL-c ratio, uric acid, glucose and Homeostasis Model Assessment of Insulin Resistance Index (HOMA-IR) (P time×treatment > 0.05). However, VCO suppressed less hunger (P time×treatment = 0.003), total satiety (P iAUC = 0.021) and total fullness (P iAUC = 0.035) responses than C. CONCLUSIONS: VCO consumption did not acutely change energy metabolism and cardiometabolic risk markers when added to a mixed breakfast but promoted less appetitive responses.